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Of Melancholy I Sing

Of Melancholy I Sing

By Gene Wilburn

“No man amongst us so sound, of so good a constitution, that hath not some impediment of body or mind” ~ Robert Burton, Anatomy of Melancholy, 1621

“Depression is the most unpleasant thing I have ever experienced… . It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different.” ~ J.K. Rowling

Depression is one of the least understood mental afflictions. In my own struggle with clinical depression I’ve met people who don’t know why I can’t just “snap out of it.” They confuse it with the mild version of “being depressed” that everyone experiences from time to time, that a good walk or game of squash can cure. Clinical depression, which I’ll refer to simply to as “depression,” is a different beast altogether. It’s a serious illness of the brain.

It was first written about extensively by Robert Burton in Anatomy of Melancholy in the 17th Century. His term, melancholy, included, among other things, what today we’d call clinical depression, and although his immensely popular book was more of a literary than a scientific masterpiece, he based his observations on real cases. Depression isn’t a modern disease.

Several specialists have pointed out that the problem with depression is that it’s invisible, and because it’s invisible, it’s easily dismissed. If those of us with depression wore a cast on our heads, like a leg or arm cast, it would likely be given more credence.

I was first diagnosed with depression shortly after 9/11 when I couldn’t shake from my mind the ghastly images of the twin towers collapsing. I was also in a difficult work situation where I was caught in the throes of a corporate takeover in which my Internet implementation team was dismantled and all our extensive project work was scrapped, not wanted by the new masters. After my severance package I retired, and within the first year of retirement had a heart attack. That was followed by two separate stent procedures, which didn’t take, followed by double-bypass heart surgery. By this time I fell into a state of depression so severe I didn’t want to get out of bed.

One of the most terrible things about depression is that it can shut down your interest in everything that formerly gave you joy, such as music, socializing, reading, even television. It can shut down your interest in life itself. Some people who experience depression become suicidal, which is why it’s important to keep an eye on family members or friends who you suspect may be depressed.

Chemical Imbalance in the Brain

Today we know more about the anatomy of depression because it’s been studied by specialists with scanning equipment, comparing depressed brains with “normal” brains. The studies indicate that the depressed brain is indeed different, with a different chemistry from a normal brain because it can’t balance its chemistry properly. This understanding has led to the development of antidepressant drugs that try to address these imbalances, especially selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitors (SSRIs) and similar drugs.

There are several variations on a theme with antidepressants because different formulae work better for some people than others. The challenge is finding the one that works for you. It’s not easy to go the course if you’ve had poor luck with the ones you’ve tried and hate the side effects, which can include heavy sweating or being left in a fuzzy state of mind. I don’t remember all the ones I tried, but they have included Celexa, Cipralex, Zoloft, Abilify, Seroquel, and my current combo, Effexor XR and Trintellix.

The problem with antidepressants is that you have to give them several weeks to see if they help, and if they don’t you often have to come off them slowly and carefully in order to prevent an even deeper dive of depression. Another problem is that some of them work for awhile, then, for unknown reasons, no longer work. Matching the right drugs with the right patient is hard work, unless, as sometimes happens, you luck out with the first one you try. Again, if you’re lucky, a period of antidepressants may fix you up to the point where you no longer need the meds.

I’ve been living with chronic depression for over ten years and have reached a fairly stable state where I’m not entirely depression free but am no longer plummeting the depths, lying in bed incapacitated. After years of altering my dosages and fine tuning them, I accept that, in my case, depression will probably never leave, but that if the drugs keep me level, that’s about as good as it’s going to get, and I just work around it the best I can. And smile in public.

Triggers

Depression is fairly common among the aged for any number of reasons. Retirement can trigger depression for many who have devoted their lives to their careers and face a void when it’s over because they haven’t developed any outside interests. Death is a trigger — the deaths of friends and family members becomes more frequent as you age. Death of a spouse can bring about depression caused by loneliness. Aging to the point of not being physically active can be a trigger as well. Financial worries can trigger it, as can major diseases such as heart and cancer. And it appears that some of us are simply unlucky in the genes we inherited, for depression can run in families.

For yourself, and others you care about, watch for the signs of depression and don’t attempt to self treat it. Get medical assistance if at all possible. The goal is to try to get back to a state where life is sweet, if imperfect. Or at least bearable, if not always sweet. And if you know someone who’s depressed, be gentle and supporting, and don’t regale that person with pep talks. If you tell a person to buck up, and they can’t, it only deepens their depression.

And should you suspect you’re undergoing depression, hang in there, and be gentle on yourself. Keep up your exercise if you possibly can, and try to eat healthy food. Seek help. Depression can be, if not cured, then at least lessened enough for you to be able to return to the land of the living. And bear in mind that you’re not alone. If you have access to Facebook, you can join MyDepressionTeam which can put you in touch with others nearby who share the affliction, as well as provide information on dealing with depression.